comparison of synthetic bone substitute and a bovine-derived xenograft in horizontal bone augmentation

Conditions: Jaw, Edentulous; Jaw, Edentulous, Partially

Summary: the objective of the study is to test the efficacy on bone formation of straumann bone ceramic as a grafting material applied in buccal bone dehiscences on simultaneously placed oral implants.

this is a randomized, controlled, split mouth, prospective, single centre study. the total study duration for each patient should be 76 weeks +/-18 months. in total 8 visits per patient are scheduled in this study. the study devices straumann bone ceramic and bio-oss are ce-marked, and approved by the fda. the products are used within the indication. one center in beligum will participate.

Eligibility criteria:
inclusion criteria: * males and females, 18 years to 80 years of age * at least two missing teeth up to full edentulous arches. * desiring implant supported restorations. * both study implants should have a self-containing (2-wall) buccal dehiscence defect after oral implant placement (at least 3.0 mm / max. 5.0 mm defect in apico-coronal aspect to be measured from the boarder of the rough surface of the oral implant to the bottom of the defect). * at least 4mm of the implant, measured from the apical end to the lowest margin of the bone level, should be covered with bone. * sufficient bone volume such that both oral implants will not encroach on vital structures and primary stability of the oral implant can be achieved; * patients must be committed to the study and must sign informed consent. * patient in good general health as documented by self assessment; * full mouth plaque score of \<20%; exclusion criteria: * any systemic medical condition that could interfere with the surgical procedure or planned treatment; * current pregnancy or breast feeding/ lactating at the time of recruitment; * physical handicaps that would interfere with the ability to perform adequate oral hygiene; * alcoholism or chronically drug abuse causing systemic compromise. * patients who smoke more than 20 cigarettes per day. * conditions or circumstances, in the opinion of the investigator, which could represent a general contra-indication for surgical procedure or would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance, or unreliability * lack of primary stability of 1 or both implant(s) at surgery, measured by hand testing. in this instance the patient must be withdrawn and treated accordingly. * mucosal diseases such as erosive lichen planus * history of local radiation therapy. * presence of osseous pathologies. * presence of oral lesions (such as ulceration, malignancy) * severe bruxing or clenching habits. * local inflammation, including untreated periodontitis. * bone surgery at the implant site(s) (bone grafts, guided tissue regeneration techniques for bone enhancement) prior to implant placement unless performed more than 6 months prior to implant placement. * patients presenting clinical and radiological signs and symptoms of maxillary sinus disease. * existing teeth in the residual dentition with untreated endodontic pathologies. * patients with inadequate oral hygiene or unmotivated for adequate home care